Rak prącia
Rokowania, prognozy i postęp choroby

Rak prącia, choć rzadki w krajach rozwiniętych, stanowi istotny problem onkologiczny w krajach rozwijających się, gdzie może stanowić 10-20% nowotworów męskich. Kluczowymi czynnikami prognostycznymi są stopień zaawansowania choroby oraz obecność i liczba zajętych węzłów chłonnych pachwinowych, które znacząco wpływają na przeżycie całkowite (OS) i specyficzne dla nowotworu (CSS). Pacjenci bez przerzutów do węzłów chłonnych (pN0) wykazują 5-letnie przeżycie powyżej 90%, podczas gdy u chorych z przerzutami wskaźnik ten spada do około 50%. Wysoki stopień histologiczny guza, inwazja naczyniowo-limfatyczna, większy rozmiar guza (>5 cm) oraz głęboka inwazja tkanek są niezależnymi czynnikami złego rokowania. Biomarkery takie jak NLR (wartości graniczne 2,6-3,59), p53, p16 oraz profile HPV+CD147+CD15+ dostarczają dodatkowych informacji prognostycznych, a sarkopenia znacząco obniża OS, co zostało uwzględnione w nomogramach predykcyjnych.

  1. Wprowadzenie do rokowania w raku prącia
    1. Znaczenie wczesnej diagnozy
  2. Kluczowe czynniki prognostyczne w raku prącia
    1. Status węzłów chłonnych jako główny czynnik rokowniczy
    2. Stopień zróżnicowania histopatologicznego guza
    3. Wielkość guza i cechy inwazyjności
    4. Wpływ podtypu histologicznego na rokowanie
  3. Biomarkery i nowsze czynniki prognostyczne
    1. Wskaźnik neutrofili do limfocytów (NLR)
    2. Mikrośrodowisko guza i biomarkery molekularne
    3. Sarkopenia jako nowy czynnik rokowniczy
  4. Statystyki przeżycia w raku prącia
    1. Ogólne wskaźniki przeżycia
    2. Wskaźniki przeżycia według stadium zaawansowania
    3. Czynniki wpływające na interpretację statystyk przeżycia
  5. Wpływ wieku na prognozę w raku prącia
  6. Znaczenie wczesnej interwencji i leczenia węzłów chłonnych
    1. Limfadenektomia profilaktyczna
    2. Znaczenie stratyfikacji radiologicznej
  7. Znaczenie monitorowania i długoterminowej opieki
    1. Kolejne rozdziały

Wprowadzenie do rokowania w raku prącia

Rak prącia jest rzadkim nowotworem złośliwym u mężczyzn w krajach rozwiniętych, jednak jego częstość występowania może sięgać nawet 10-20% wszystkich nowotworów męskich w niektórych krajach rozwijających się.1 Rokowanie w tej chorobie jest uzależnione od wielu czynników, przy czym najważniejszymi determinantami przeżycia są obecność i stopień zajęcia węzłów chłonnych pachwinowych.23 Rokowanie i przeżywalność w raku prącia zależą od licznych aspektów, a tylko lekarz znający pełną historię medyczną pacjenta, typ, stopień zaawansowania, zróżnicowanie i inne cechy nowotworu, zastosowane leczenie oraz odpowiedź na terapię może połączyć te informacje ze statystykami przeżywalności, aby określić indywidualne rokowanie.4

Znaczenie wczesnej diagnozy

Stopień zaawansowania w momencie diagnozy jest istotnym czynnikiem prognostycznym w raku prącia. Im niższy stopień zaawansowania, tym lepsze rokowanie. Nowotwory zlokalizowane na powierzchni skóry prącia mają korzystniejsze rokowanie niż te, które wniknęły przez skórę do tkanek erekcyjnych prącia (ciał jamistych lub gąbczastych). Wczesne rozpoznanie raka prącia zazwyczaj umożliwia całkowite wyleczenie.5 W przypadku wcześnie wykrytych zmian leczenie jest prostsze i daje najlepsze wyniki, a prawdopodobieństwo wystąpienia działań niepożądanych lub powikłań jest mniejsze.6

Kluczowe czynniki prognostyczne w raku prącia

Status węzłów chłonnych jako główny czynnik rokowniczy

Obecność i stopień zajęcia węzłów chłonnych są najważniejszymi czynnikami prognostycznymi związanymi z przeżyciem pacjentów z rakiem prącia.7 Rak prącia, który nie rozprzestrzenił się do węzłów chłonnych, ma lepsze rokowanie niż ten, który już dał przerzuty. Liczba zajętych węzłów chłonnych oraz grupa węzłów, do których nowotwór się rozprzestrzenił, również odgrywają istotną rolę w przewidywaniu przeżycia. Mężczyźni, u których nowotwór zajął tylko jeden węzeł chłonny pachwinowy, mają większe szanse na przeżycie niż pacjenci z przerzutami do wielu węzłów lub do innej grupy węzłów chłonnych.89 U pacjentów bez przerzutów do węzłów chłonnych (pN0) zgłaszano doskonałe długoterminowe przeżycie.10

Badania wykazały, że przeżycie całkowite (OS) pacjentów z chorobą pN0 i pN+ wynosi odpowiednio 119 i 54 miesiące.11 Wczesne i dokładne przewidywanie statusu przerzutów do węzłów chłonnych (LNM) może znacząco zmniejszyć nadmierne leczenie i promować aktywną terapię, poprawiając przeżywalność pacjentów.12 Wskaźnik 5-letniego przeżycia pacjentów bez przerzutów do węzłów chłonnych przekracza 90%, natomiast u pacjentów z przerzutami wynosi około 50%.13

Stopień zróżnicowania histopatologicznego guza

Stopień zróżnicowania histologicznego guza jest jednym z najważniejszych niezależnych czynników prognostycznych u pacjentów z rakiem prącia i klinicznie ujemnymi węzłami chłonnymi, którzy nie byli poddani regionalnej limfadenektomii.1415 Nowotwory o niższym stopniu złośliwości mają lepsze rokowanie niż te o wyższym stopniu. Guzy zlokalizowane na napletku lub żołędzi prącia zwykle charakteryzują się niższym stopniem złośliwości. Większość guzów zajmujących trzon prącia ma tendencję do wyższego stopnia złośliwości. Im wyższy stopień guza, tym większe prawdopodobieństwo, że nowotwór rozprzestrzenił się do węzłów chłonnych.16

Badania wykazały, że wysoki stopień histologiczny był niezależnym czynnikiem predykcyjnym dla przeżycia całkowitego (GS) i przeżycia specyficznego dla nowotworu (CSS). Pacjenci z guzem o wysokim stopniu złośliwości mieli wyższe prawdopodobieństwo zgonu z powodu raka (RR 14,8; p=0,019) i zgonów ogólnych (RR 1,86; p=0,023) w porównaniu z pacjentami z guzem o niskim lub średnim stopniu złośliwości.1718 Wysoki stopień histologiczny pozostaje czynnikiem ryzyka zgonu z powodu raka prącia, nawet w podgrupach bez przerzutów do węzłów chłonnych.19

Wielkość guza i cechy inwazyjności

Guzy większe niż 5 cm oraz guzy pokrywające ponad 75% trzonu prącia mają zwiększone ryzyko rozprzestrzeniania się do węzłów chłonnych i gorsze rokowanie.20 Nowotwór, który nie rozprzestrzenił się do naczyń krwionośnych lub limfatycznych (brak inwazji naczyniowo-limfatycznej), ma tendencję do lepszego rokowania niż nowotwór, który zajął naczynia krwionośne lub limfatyczne.21 Inwazja naczyniowo-limfatyczna/żylna została potwierdzona jako ważny czynnik prognostyczny statusu węzłów chłonnych.22

Wartościowe predyktory przerzutów do węzłów chłonnych pachwinowych w raku prącia obejmują inwazyjne cechy kliniczno-patologiczne, takie jak: wyższy stopień zaawansowania, obecność inwazji naczyniowo-limfatycznej (LVI), inwazja ciał jamistych, inwazja cewki moczowej, inwazja nerwów, głębsza inwazja, kliniczne zajęcie węzłów chłonnych (cN+), większy rozmiar guza, wyższy stopień złośliwości, pionowy wzorzec wzrostu oraz podtyp histopatologiczny o wysokim i pośrednim ryzyku.23

Wpływ podtypu histologicznego na rokowanie

Niektóre typy raka prącia mają lepsze rokowanie. Rak brodawkowaty (verrucous carcinoma) i rak podstawnokomórkowy są zwykle niskiego stopnia złośliwości, rzadko rozprzestrzeniają się do innych części ciała i mają dobre rokowanie. Czerniak prącia ma tendencję do szybkiego wzrostu i rozprzestrzeniania się, w momencie diagnozy często jest w zaawansowanym stadium.24 Badania wykazały, że podtyp raka płaskonabłonkowego o cechach mięsakowatych (sarcomatoid SCC) jest jednym z czynników uwzględnianych w nomogramie prognostycznym raka prącia, przewidującym 2-letnie przeżycie całkowite.25

Biomarkery i nowsze czynniki prognostyczne

Wskaźnik neutrofili do limfocytów (NLR)

Różne biomarkery są wykorzystywane do przewidywania rokowania w nowotworach, w tym wskaźnik neutrofili do limfocytów (NLR). Badania wykazały, że NLR jest niezależnym predyktorem zajęcia węzłów chłonnych (LNM) i przeżycia specyficznego dla nowotworu (CSS) w raku prącia. Wartości graniczne NLR w badaniach wahały się od 2,6 do 3,59. Meta-analiza wykazała, że pacjenci z rakiem prącia i wysokim NLR mieli gorsze wyniki w zakresie przerzutów do węzłów chłonnych i przeżycia specyficznego dla nowotworu.2627

Wykazano, że wysoki NLR był niezależnym predyktorem gorszego przeżycia specyficznego dla nowotworu (CSS) w raku prącia. Jednakże, badania nie wykazały istotnej różnicy w przeżyciu całkowitym (OS) w oparciu o stratyfikację NLR.28

Mikrośrodowisko guza i biomarkery molekularne

Wpływ mikrośrodowiska guza (TME) na przeżycie pacjentów z rakiem prącia jest coraz bardziej badany. Biomarkery takie jak HPV, p63, CD15, DKK1 i CD147 łączą mikrośrodowisko guza sprzyjające rozwojowi nowotworu z wyższą klasyfikacją TNM, odzwierciedlającą bardziej agresywne i przerzutujące nowotwory.29

Istnieje zauważalny potencjał predykcyjny dotyczący przeżycia pacjentów z profilami biomarkerów, wykraczający poza możliwości pojedynczego biomarkera. Po zbadaniu istotnych wzajemnych zależności, status HPV+CD147+CD15+ był najsilniejszym profilem przewidującym przeżycie wolne od przerzutów u pacjentów z rakiem prącia.30 Sam status HPV nie miał istotnego wpływu na przeżycie, jednak pacjenci z rakiem prącia o statusie HPV+p63+ mieli znacznie zmniejszone przeżycie wolne od przerzutów (MFS) z tendencją do gorszego rokowania w zakresie przeżycia całkowitego (OS) i przeżycia specyficznego dla guza (TSS).31

Wykazano również, że marker p53 może przewidywać przeżycie. Dodatni wynik p53 jest związany ze złym rokowaniem. W przypadku inwazyjnych raków płaskonabłonkowych, p16 (INK4a) okazał się silnie skorelowany z dobrym rokowaniem, doskonałą powtarzalnością i zwiększonym przeżyciem specyficznym dla nowotworu (CSS).32

Sarkopenia jako nowy czynnik rokowniczy

Badania nad nowymi wskaźnikami prognostycznymi w raku prącia wykazały, że sarkopenia (utrata masy mięśniowej) znacząco obniża przeżycie całkowite (OS) u pacjentów z chorobą przerzutową. Analiza większej kohorty pacjentów (n=338) wykazała, że sarkopenia zmniejsza przeżycie całkowite niezależnie od obecności choroby przerzutowej.33

Na podstawie tych badań opracowano nomogram prognostyczny dla raka prącia, przewidujący 2-letnie przeżycie całkowite, uwzględniający sarkopenię, wskaźnik chorób współistniejących Charlsona, zajęcie węzłów chłonnych, przerzuty odległe i podtyp raka płaskonabłonkowego o cechach mięsakowatych jako zmienne. Chociaż zalecana jest dalsza walidacja tego markera kruchości, sarkopenia okazała się być użytecznym wskaźnikiem prognostycznym, zarówno samodzielnie, jak i w nomogramie predykcyjnym, do stratyfikacji ryzyka u pacjentów z rakiem prącia w momencie diagnozy.34

Statystyki przeżycia w raku prącia

Ogólne wskaźniki przeżycia

Statystyki przeżycia dla raka prącia są bardzo ogólnymi szacunkami i muszą być interpretowane z dużą ostrożnością. Ponieważ opierają się na doświadczeniach grup osób, nie mogą być używane do przewidywania szans przeżycia konkretnej osoby.3536

W Kanadzie 5-letnie przeżycie netto dla raka prącia wynosi 65%. Oznacza to, że około 65% mężczyzn z rozpoznaniem raka prącia przeżyje co najmniej 5 lat. Generalnie, im wcześniej rak prącia zostanie zdiagnozowany i leczony, tym lepsze rokowanie.37

Wskaźniki przeżycia według stadium zaawansowania

Przeżycie w zależności od stadium raka prącia jest podawane jako 5-letnie względne przeżycie. Względne przeżycie określa, jak duże jest prawdopodobieństwo, że osoby z nowotworem przeżyją po rozpoznaniu w porównaniu z osobami w populacji ogólnej, które nie mają nowotworu, ale mają podobne cechy (takie jak wiek i płeć).38 Poniżej przedstawiono wskaźniki 5-letniego względnego przeżycia według stadium zaawansowania:

  • Rak prącia ograniczony do prącia (stadia 0-2): 85%39
  • Rak prącia z przerzutami do węzłów chłonnych, ale nie do odległych obszarów (stadium 3): 59%40
  • Rak prącia z przerzutami do odległych obszarów ciała (stadium 4): 11%41

Podobne dane zostały opublikowane przez American Cancer Society. W przypadku nowotworów, które nie rozprzestrzeniły się poza prącie, wskaźnik 5-letniego przeżycia wynosi około 85%. Dla nowotworów, które rozprzestrzeniły się do pobliskich obszarów lub węzłów chłonnych, wskaźnik 5-letniego przeżycia wynosi około 59%. Dla nowotworów, które rozprzestrzeniły się do innych części ciała, wskaźnik 5-letniego przeżycia wynosi około 11%.42

Czynniki wpływające na interpretację statystyk przeżycia

Ważne jest, aby pamiętać, że statystyki przeżycia są szacunkami i często opierają się na wcześniejszych wynikach dużej liczby osób, które miały określony typ nowotworu, ale nie mogą przewidzieć, co stanie się w konkretnym przypadku.43 Wskaźnik względnego przeżycia porównuje mężczyzn z tym samym typem i stadium raka prącia do mężczyzn w ogólnej populacji.44

Te liczby odnoszą się tylko do stadium nowotworu w momencie pierwszej diagnozy i nie uwzględniają wszystkich czynników. Mężczyźni, u których obecnie diagnozuje się raka prącia, mogą mieć lepsze rokowanie niż pokazują te liczby, ze względu na postęp w metodach diagnostycznych i leczniczych.45

Wpływ wieku na prognozę w raku prącia

Przeprowadzono badania porównujące odległe wyniki leczenia raka płaskonabłonkowego prącia u mężczyzn w wieku ≤50 lat w porównaniu z mężczyznami w wieku >50 lat. Przeżycie całkowite (OS) w 2 lata dla grupy ≤50 lat wynosiło 86%, a dla grupy >50 lat 80,6%. Przeżycie 5-letnie wynosiło odpowiednio 78,1% dla młodszej grupy i 63,1% dla starszej (p=0,01). Przeżycie 10-letnie wynosiło 72,3% dla grupy ≤50 lat i 45,6% dla grupy >50 lat.46

Przeżycie specyficzne dla choroby (DSS) w 2 lata wynosiło 87,2% dla grupy ≤50 lat i 87,8% dla grupy >50 lat. Przeżycie 5-letnie DSS wynosiło 80,9% dla młodszej grupy i 78,2% dla starszej (p=0,74). Przeżycie wolne od nawrotu (RFS) wynosiło 93,1% w grupie ≤50 lat (vs 96,5% w grupie >50 lat) po 2 latach i 90% (vs 88,5% w grupie >50 lat) po 5 latach (p=0,81).47

Chociaż 5-letnie przeżycie całkowite było wyższe u pacjentów ≤50 lat w porównaniu z pacjentami >50 lat (78,1% vs 63,1%, p<0,001), przeżycie specyficzne dla choroby po 5 latach było podobne (80,9% vs 78,2%, p=0,74). Nie jest to zaskakujące, ponieważ starsi pacjenci częściej umierali z innych przyczyn w porównaniu z młodszymi dorosłymi, którzy byli bardziej sprawni i zdrowsi. Generalnie badania te wskazują, że rak prącia może być śmiertelny we wszystkich grupach wiekowych, w tym u młodych pacjentów.48

Znaczenie wczesnej interwencji i leczenia węzłów chłonnych

Limfadenektomia profilaktyczna

Przeżycie pacjentów z rakiem prącia jest ściśle związane z czasem wykonania profilaktycznej limfadenektomii miednicy. Wszystkim pacjentom z wysokim ryzykiem przerzutów do węzłów chłonnych należy zaproponować wycięcie węzłów chłonnych w ciągu trzech miesięcy od rozpoznania, dopóki nowe narzędzia predykcyjne nie zostaną zwalidowane.49

Status węzłów chłonnych pachwinowych w momencie rozpoznania raka prącia i jego wczesne leczenie odgrywają kluczową rolę w podejściu terapeutycznym do pacjentów z rakiem prącia. Wielu autorów wykazało, że przeżycie pacjentów jest determinowane przez status węzłów chłonnych pachwinowych w momencie rozpoznania.50

Międzynarodowe wytyczne sugerują przeprowadzenie dokładnego wycięcia węzłów chłonnych pachwinowych i miednicznych w ciągu 3 miesięcy od początkowej diagnozy. To zalecenie opiera się na związku między obecnością przerzutów do węzłów chłonnych a wskaźnikami przeżycia pacjentów.51 Wytyczne EAU (Europejskiego Towarzystwa Urologicznego) podkreślają, że opóźnienie leczenia węzłów chłonnych o więcej niż 3 do 6 miesięcy może zmniejszyć przeżycie wolne od choroby.52

Znaczenie stratyfikacji radiologicznej

Badania wykazują, że skuteczność biopsji wartowniczego węzła chłonnego (DSNB) poprawia się dzięki ulepszonej radiologicznej stratyfikacji pacjentów do DSNB lub limfadenektomii pachwinowej (ILND).53 Wykazano również różnicę w przeżyciu całkowitym w zależności od tego, które badanie stopniujące przeprowadzono na początku (DSNB vs ILND – 108 vs 72 miesiące, p<0,0001).54

Standardyzacja raportowania badań ultrasonograficznych i wykorzystanie obrazowania przekrojowego do stratyfikacji pacjentów na cN0 i cN+ poprawia wyniki procedur stopniowania węzłów chłonnych. Badania wykazały średnie całkowite przeżycie na poziomie 85,6% i CSS na poziomie 100% u pacjentów pN0 po DSNB.55

Znaczenie monitorowania i długoterminowej opieki

Wczesne rozpoznanie i agresywne leczenie raka prącia oraz ścisła obserwacja są pilnie potrzebne, aby poprawić wyniki leczenia.56 Jednakże obserwacja pacjentów w wielu badaniach była ogólnie słaba, a dane dotyczące długoterminowego przeżycia nie zawsze były dostępne.57

Dokładne przewidywanie przerzutów do węzłów chłonnych pachwinowych może wskazać pacjentów będących najlepszymi kandydatami do limfadenektomii pachwinowej, co mogłoby nie tylko osiągnąć najlepszy wskaźnik przeżycia dla pacjentów z ukrytymi przerzutami, ale także uniknąć niepotrzebnego leczenia dla pacjentów z niskim ryzykiem rozwoju przerzutów do węzłów chłonnych.58

Na obecną chwilę czynniki kliniczno-patologiczne, takie jak stopień zaawansowania i zróżnicowanie pierwotnej zmiany, pozostają ważnymi czynnikami predykcyjnymi przerzutów do węzłów chłonnych. Badanie nieinwazyjnych wskaźników hematologicznych jest jednym z ważnych kierunków przyszłych badań przedoperacyjnych.59

Wyniki badań podkreślają potrzebę analizy mikrośrodowiska guza i opracowania wieloparametrowych złożonych skal, które odzwierciedlają fundamentalne relacje między nowotworem a układem odpornościowym, aby dostosować interwencje terapeutyczne w oparciu o rzeczywistą dynamikę immunologiczną nowotworu.60

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  1. 12.04.2026
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Materiały źródłowe

  • #1 Ten-year surgical experiences with penile cancer at a tertiary care hospital in northwestern Tanzania: a retrospective study of 236 patients | World Journal of Surgical Oncology | Full Text
    https://wjso.biomedcentral.com/articles/10.1186/s12957-015-0482-0
    Penile cancer is an uncommon malignancy in developed countries, but the incidence is as high as 10% to 20% of all male cancers in some developing countries. […] The majority of patients present late with advanced stage of the disease. Early detection of primary cancer at an early stage may improve the prognosis. […] HIV positivity, histopathological stage and grade of the tumor, and presence of metastases at the time of diagnosis were the main predictors of death. […] The majority of patients presented late with an advanced stage of the disease (Jacksons stages III and IV) with operable or inoperable inguinal metastases and tumors involving adjacent structures or distant metastases which is in keeping with other studies performed in developing countries. […] The presence of metastases in the regional lymph nodes is the main factor predicting an unfavorable prognosis for patients with penile cancer.
  • #2
    https://discovery.ucl.ac.uk/id/eprint/10169098/
    Developing novel prognostic indicators for the management of metastatic penile cancer. […] The prognosis of this disease is dictated by the presence of metastasis in the inguinal lymph nodes – currently the only reliable prognostic indicator. […] Following the case-control study analysis of patients with metastatic and non-metastatic penile cancer (n=100), I identified that sarcopenia significantly reduced overall survival (OS) in those with metastatic disease. A larger cohort analysis [n=338,Metastatic(114)-Non-Metastatic(193)-pN1-N2(31)] identified that sarcopenia reduced OS irrespective of the presence of metastatic disease. […] We finally produced a penile cancer prognosis nomogram predicting 2-year OS incorporating Sarcopenia(TMA), Charlson Comorbidity Index, Lymph node involvement, Distant metastases and Sarcomatoid SCC subtype as variables. […] Although further validation of this frailty marker is advisable, sarcopenia has proven in this thesis, that it can be used as a prognostic indicator on its own as well as in a predictive Nomogram to risk-stratify patients with penile cancer at the time of their diagnosis.
  • #3 Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5117969/
    Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy. […] The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. […] Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). […] High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer.
  • #4 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    If you have penile cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage, grade and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Stage at diagnosis is an important prognostic factor for penile cancer. The lower the stage of penile cancer, the better the outcome. Tumours that are on the surface of the skin of the penis have a more favourable prognosis than those that have grown through the skin to the erectile tissues of the penis (corpus spongiosum or cavernosum). When diagnosed at an early stage, penile cancer can usually be cured.
  • #5 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    If you have penile cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage, grade and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Stage at diagnosis is an important prognostic factor for penile cancer. The lower the stage of penile cancer, the better the outcome. Tumours that are on the surface of the skin of the penis have a more favourable prognosis than those that have grown through the skin to the erectile tissues of the penis (corpus spongiosum or cavernosum). When diagnosed at an early stage, penile cancer can usually be cured.
  • #6 Penile Cancer: Your Chances for Recovery (Prognosis) | Saint Luke’s Health System
    https://www.saintlukeskc.org/health-library/penile-cancer-your-chances-recovery-prognosis
    Prognosis is the word your healthcare team may use to describe your chances of recovering from cancer. Or it may mean your likely outcome from cancer and cancer treatment. […] A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. […] If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. This means you’re expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. […] The following are survival rates for penile cancer, published by the American Cancer Society. These come from statistics compiled by the National Cancer Institute: For cancers that have not spread outside the penis, the 5-year survival rate is about 85%. For cancers that have spread into nearby areas or lymph nodes, the 5-year survival rate is about 59%. For cancers that have spread to other parts of the body, the 5-year survival rate is about 11%. […] When penile cancer is found early, its treatment is simple and works as best it can. The treatment is less likely to cause side effects or complications.
  • #7 Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5117969/
    Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy. […] The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. […] Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). […] High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer.
  • #8 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Whether the cancer has spread to the lymph nodes is related to the stage of the tumour and is an important prognostic factor. Penile cancer that has not spread to lymph nodes has a better prognosis than penile cancer that has spread to lymph nodes. The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes. […] Tumours that are larger than 5 cm and tumours that cover more than 75% of the shaft of the penis have an increased risk of spreading to the lymph nodes and a poorer prognosis. […] Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood or lymph vessels.
  • #9 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for penile cancer is 65%. This means that about 65% of men diagnosed with penile cancer will survive least 5 years. […] Generally, the earlier penile cancer is diagnosed and treated, the better the outcome. […] The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes.
  • #10 Improved outcome in penile cancer with radiologically enhanced stratification protocol for lymph node staging procedures: a study in 316 inguinal basins with a mean follow-up of 5 years | BMC Urology | Full Text
    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01303-9
    Lymph node metastasis is the main determinant of survival in penile cancer patients. […] The performance of DSNB improved with enhanced radiological stratification of patients to either DSNB or ILND. […] Lymph node (LN) metastasis is the single most important prognostic factor in patients with squamous cell carcinoma of the penis (SCCp). […] Patients with pathologically node-negative (pN0) disease have been reported to have excellent long-term survival. […] The overall survival (OS) of patients with pN0 and pN+disease is 119 and 54 months, respectively. […] There was also a difference in overall survival depending on which staging investigation was done at the outset (i.e., DSNB vs ILND (108 vs 72 months, p0.0001)). […] To our knowledge this is the first paper to report survival data in all lymph node staging procedure in penile cancer.
  • #11 Improved outcome in penile cancer with radiologically enhanced stratification protocol for lymph node staging procedures: a study in 316 inguinal basins with a mean follow-up of 5 years | BMC Urology | Full Text
    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01303-9
    Lymph node metastasis is the main determinant of survival in penile cancer patients. […] The performance of DSNB improved with enhanced radiological stratification of patients to either DSNB or ILND. […] Lymph node (LN) metastasis is the single most important prognostic factor in patients with squamous cell carcinoma of the penis (SCCp). […] Patients with pathologically node-negative (pN0) disease have been reported to have excellent long-term survival. […] The overall survival (OS) of patients with pN0 and pN+disease is 119 and 54 months, respectively. […] There was also a difference in overall survival depending on which staging investigation was done at the outset (i.e., DSNB vs ILND (108 vs 72 months, p0.0001)). […] To our knowledge this is the first paper to report survival data in all lymph node staging procedure in penile cancer.
  • #12 Penile cancer: prognostic factors for lymph node involvement—a narrative review – Li – AME Medical Journal
    https://amj.amegroups.org/article/view/7693/html
    Several factors are associated with the metastasis of penile squamous cell carcinoma (PSCC) to inguinal lymph nodes. […] The 5-year survival rate of patients without LNM is higher than 90% and patients with LNM is about 50%. […] The management of lymph nodes with appropriate staging directly affects the prognosis and survival of patients. […] Therefore, the timely and accurate prediction of patients’ LNM status can significantly reduce overtreatment, and promote active treatment to improve patient survival. […] The prognosis of cancer patients were also is influenced by Body mass index (BMI). […] The histological grade of the tumour has been proven to be an important index for predicting regional LNM. […] Lymphovascular/venous invasion was confirmed to be an important prognostic factor of lymph node status.
  • #13 Penile cancer: prognostic factors for lymph node involvement—a narrative review – Li – AME Medical Journal
    https://amj.amegroups.org/article/view/7693/html
    Several factors are associated with the metastasis of penile squamous cell carcinoma (PSCC) to inguinal lymph nodes. […] The 5-year survival rate of patients without LNM is higher than 90% and patients with LNM is about 50%. […] The management of lymph nodes with appropriate staging directly affects the prognosis and survival of patients. […] Therefore, the timely and accurate prediction of patients’ LNM status can significantly reduce overtreatment, and promote active treatment to improve patient survival. […] The prognosis of cancer patients were also is influenced by Body mass index (BMI). […] The histological grade of the tumour has been proven to be an important index for predicting regional LNM. […] Lymphovascular/venous invasion was confirmed to be an important prognostic factor of lymph node status.
  • #14 Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5117969/
    Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy. […] The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. […] Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). […] High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer.
  • #15 SciELO Brazil – Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy Tumor histologic grade is the most important prognostic factor in
    https://www.scielo.br/j/ibju/a/JknB3Xzf6scpkgSnMxgBf3v/?lang=en
    High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer. […] High grade was an independent predictive factor for GS and CSS. Patients with high grade tumor had higher probability of death due to cancer (RR 14.8; p=0.019) and global deaths (RR 1.86; p=0.023) when compared to those with low or intermediate grade. […] Histologic grade was an independent predictive factor of risk of death and death-specific. […] High histologic grade remains a risk factor for death due to penile carcinoma, even in subgroups without lymph node metastasis.
  • #16 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Penile cancers that have a lower grade have a better prognosis than those with a higher grade. Tumours on the foreskin or glans (head) of the penis tend to be lower grade. Most tumours that affect the shaft of the penis tend to be higher grade. The higher the grade of the tumour, the higher the chance that the cancer has spread (metastasized) to the lymph nodes. […] Some types of penile cancer have a better prognosis. Verrucous carcinoma and basal cell carcinoma are usually low grade, rarely spread to other parts of the body and have a good prognosis. Melanoma of the penis tends to grow and spread more quickly and is often at an advanced stage when diagnosed. […] Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
  • #17 Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5117969/
    High grade was an independent predictive factor for GS and CSS. Patients with high grade tumor had higher probability of death due to cancer (RR 14.8; p=0.019) and global deaths (RR 1.86; p=0.023) when compared to those with low or intermediate grade. […] Histologic grade was an independent predictive factor of risk of death and death-specific. […] Main independent prognostic factor for CSS was the presence of high grade primary tumor. […] High histologic grade remains a risk factor for death due to penile carcinoma, even in subgroups without lymph node metastasis.
  • #18 SciELO Brazil – Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy Tumor histologic grade is the most important prognostic factor in
    https://www.scielo.br/j/ibju/a/JknB3Xzf6scpkgSnMxgBf3v/?lang=en
    High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer. […] High grade was an independent predictive factor for GS and CSS. Patients with high grade tumor had higher probability of death due to cancer (RR 14.8; p=0.019) and global deaths (RR 1.86; p=0.023) when compared to those with low or intermediate grade. […] Histologic grade was an independent predictive factor of risk of death and death-specific. […] High histologic grade remains a risk factor for death due to penile carcinoma, even in subgroups without lymph node metastasis.
  • #19 SciELO Brazil – Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy Tumor histologic grade is the most important prognostic factor in
    https://www.scielo.br/j/ibju/a/JknB3Xzf6scpkgSnMxgBf3v/?lang=en
    High histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years. […] Presence and extension of involvement of inguinal lymph nodes are the most important prognostic factors related to survival of patients with penile cancer. […] High grade was an independent predictive factor for GS and CSS. Patients with high grade tumor had higher probability of death due to cancer (RR 14.8; p=0.019) and global deaths (RR 1.86; p=0.023) when compared to those with low or intermediate grade. […] Histologic grade was an independent predictive factor of risk of death and death-specific. […] High histologic grade remains a risk factor for death due to penile carcinoma, even in subgroups without lymph node metastasis.
  • #20 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Whether the cancer has spread to the lymph nodes is related to the stage of the tumour and is an important prognostic factor. Penile cancer that has not spread to lymph nodes has a better prognosis than penile cancer that has spread to lymph nodes. The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes. […] Tumours that are larger than 5 cm and tumours that cover more than 75% of the shaft of the penis have an increased risk of spreading to the lymph nodes and a poorer prognosis. […] Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood or lymph vessels.
  • #21 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Whether the cancer has spread to the lymph nodes is related to the stage of the tumour and is an important prognostic factor. Penile cancer that has not spread to lymph nodes has a better prognosis than penile cancer that has spread to lymph nodes. The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes. […] Tumours that are larger than 5 cm and tumours that cover more than 75% of the shaft of the penis have an increased risk of spreading to the lymph nodes and a poorer prognosis. […] Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood or lymph vessels.
  • #22 Penile cancer: prognostic factors for lymph node involvement—a narrative review – Li – AME Medical Journal
    https://amj.amegroups.org/article/view/7693/html
    Several factors are associated with the metastasis of penile squamous cell carcinoma (PSCC) to inguinal lymph nodes. […] The 5-year survival rate of patients without LNM is higher than 90% and patients with LNM is about 50%. […] The management of lymph nodes with appropriate staging directly affects the prognosis and survival of patients. […] Therefore, the timely and accurate prediction of patients’ LNM status can significantly reduce overtreatment, and promote active treatment to improve patient survival. […] The prognosis of cancer patients were also is influenced by Body mass index (BMI). […] The histological grade of the tumour has been proven to be an important index for predicting regional LNM. […] Lymphovascular/venous invasion was confirmed to be an important prognostic factor of lymph node status.
  • #23 Predictors of inguinal lymph node metastasis in penile cancer patients | CMAR
    https://www.dovepress.com/predictors-of-inguinal-lymph-node-metastasis-in-penile-cancer-patients-peer-reviewed-fulltext-article-CMAR
    We identified valuable predictors of LNM in penile cancer patients, such as tumor-associated biomarkers (NLR, CRP, PD-L1, SCC-Ag, and P53 protein) and invasive clinicopathologic characteristics (higher stage, LVI, cavernosum invasion, urethra invasion, nerve invasion, deeper invasion, cN+, larger tumor size, higher grade, vertical growth pattern, and high- and intermediate-risk histopathological subtype).
  • #24 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Penile cancers that have a lower grade have a better prognosis than those with a higher grade. Tumours on the foreskin or glans (head) of the penis tend to be lower grade. Most tumours that affect the shaft of the penis tend to be higher grade. The higher the grade of the tumour, the higher the chance that the cancer has spread (metastasized) to the lymph nodes. […] Some types of penile cancer have a better prognosis. Verrucous carcinoma and basal cell carcinoma are usually low grade, rarely spread to other parts of the body and have a good prognosis. Melanoma of the penis tends to grow and spread more quickly and is often at an advanced stage when diagnosed. […] Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
  • #25
    https://discovery.ucl.ac.uk/id/eprint/10169098/
    Developing novel prognostic indicators for the management of metastatic penile cancer. […] The prognosis of this disease is dictated by the presence of metastasis in the inguinal lymph nodes – currently the only reliable prognostic indicator. […] Following the case-control study analysis of patients with metastatic and non-metastatic penile cancer (n=100), I identified that sarcopenia significantly reduced overall survival (OS) in those with metastatic disease. A larger cohort analysis [n=338,Metastatic(114)-Non-Metastatic(193)-pN1-N2(31)] identified that sarcopenia reduced OS irrespective of the presence of metastatic disease. […] We finally produced a penile cancer prognosis nomogram predicting 2-year OS incorporating Sarcopenia(TMA), Charlson Comorbidity Index, Lymph node involvement, Distant metastases and Sarcomatoid SCC subtype as variables. […] Although further validation of this frailty marker is advisable, sarcopenia has proven in this thesis, that it can be used as a prognostic indicator on its own as well as in a predictive Nomogram to risk-stratify patients with penile cancer at the time of their diagnosis.
  • #26 Prognostic value of neutrophil-to-lymphocyte ratio (NLR) in penile cancer: A systematic review and meta-analysis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9486611/
    Penile cancer is rare among male malignancies. Various biomarkers have been used to predict the prognosis of cancer, one of which is the neutrophil to lymphocyte ratio (NLR). Therefore, we conducted this systematic review and meta-analysis to evaluate the prognostic value of NLR in penile cancer. […] A total of six retrospective studies were included in the analysis. The cut-off values of NLR in the included studies ranged from 2.6 to 3.59. Meta-analysis showed that penile cancer patients with high NLR had worse LNM and CSS based on the univariate analysis (OR 3.56, 95% CI 2.38, 5.32, p 0.01; HR 4.19, 95% CI 2.19, 8.01, p = 0.0; respectively). Furthermore, the meta-analysis revealed that NLR is an independent predictor of LNM and CSS (OR 6.67, 95% CI 2.44, 18.22, p 0.01; HR 2.15, 95% CI 1.23, 3.73, p 0.01; respectively). However, NLR failed to show as independent predictor for OS (HR 1.69,95% CI 0.95,3.00, p = 0.07).
  • #27 Prognostic value of neutrophil-to-lymphocyte ratio (NLR) in penile cancer: A systematic review and meta-analysis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9486611/
    NLR is an independent predictor of LNM and CSS. However, NLR is not proven to be an independent predictor of OS in this study. […] NLR is an independent predictor for lymph node involvement. Forest plot analyses revealed that high NLR was associated with an increased probability of LNM. […] The Forest plot of the adjusted OR also showed that high NLR was an independent predictor for LNM. […] High NLR was found to be an independent predictor for worse CSS in penile cancer. Nevertheless, our study shows no significant difference in OS based on NLR stratification. […] This study demonstrated the value of NLR as an independent predictor for LNM and CSS in penile cancer. However, NLR in not proven to be an independent predictor for OS.
  • #28 Prognostic value of neutrophil-to-lymphocyte ratio (NLR) in penile cancer: A systematic review and meta-analysis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9486611/
    NLR is an independent predictor of LNM and CSS. However, NLR is not proven to be an independent predictor of OS in this study. […] NLR is an independent predictor for lymph node involvement. Forest plot analyses revealed that high NLR was associated with an increased probability of LNM. […] The Forest plot of the adjusted OR also showed that high NLR was an independent predictor for LNM. […] High NLR was found to be an independent predictor for worse CSS in penile cancer. Nevertheless, our study shows no significant difference in OS based on NLR stratification. […] This study demonstrated the value of NLR as an independent predictor for LNM and CSS in penile cancer. However, NLR in not proven to be an independent predictor for OS.
  • #29 The impact of the tumor microenvironment on the survival of penile cancer patients | Scientific Reports
    https://www.nature.com/articles/s41598-024-70855-z
    PeCa is a rare entity with rising incidence rates due to increased infections with human papillomaviruses (HPV). […] The candidate biomarkers HPV, p63, CD15, DKK1, and CD147 linked a tumor-promoting TME with a higher TNM classification reflecting more aggressive and metastasizing cancers. […] There is a notable predictive potential regarding the survival of patients with biomarker profiles beyond the potency of the individual biomarker. […] After deciphering relevant interdependencies, the HPV+CD147+CD15+status was the most potent profile predicting metastasis-free survival of PeCa patients. […] The results of this report underscore the need for analysis of the TME and the development of multi-parameter composite scores that reflect fundamental cancer-immune relationships to tailor therapeutic interventions based on actual cancer immune dynamics.
  • #30 The impact of the tumor microenvironment on the survival of penile cancer patients | Scientific Reports
    https://www.nature.com/articles/s41598-024-70855-z
    PeCa is a rare entity with rising incidence rates due to increased infections with human papillomaviruses (HPV). […] The candidate biomarkers HPV, p63, CD15, DKK1, and CD147 linked a tumor-promoting TME with a higher TNM classification reflecting more aggressive and metastasizing cancers. […] There is a notable predictive potential regarding the survival of patients with biomarker profiles beyond the potency of the individual biomarker. […] After deciphering relevant interdependencies, the HPV+CD147+CD15+status was the most potent profile predicting metastasis-free survival of PeCa patients. […] The results of this report underscore the need for analysis of the TME and the development of multi-parameter composite scores that reflect fundamental cancer-immune relationships to tailor therapeutic interventions based on actual cancer immune dynamics.
  • #31 The impact of the tumor microenvironment on the survival of penile cancer patients | Scientific Reports
    https://www.nature.com/articles/s41598-024-70855-z
    The HPV status itself had no significant impact on survival. […] Notably, PeCa specimens with an HPV+p63 status had a significantly reduced MFS with a trend towards survival disadvantage regarding OS and TSS. […] Previous results demonstrated that patients with a triple positive status (HPV+p63+CD15) are at high risk of dedifferentiated, invasive growing, and metastasizing cancers. […] In summary, these data suggest that patients with a tumor biology characterized by DKK1, p63 and CD15, have a reduced survival prognosis due to more aggressive growing cancers, as previously suggested. […] The data landscape so far suggests a different and significantly more adverse tumor biology if CD147 is induced by viral oncoproteins and may amplify TAN-fueled carcinogenesis. […] Notably, the Kaplan Meier survival estimates underlined the potential of the CD147+CD15 status to predict the survival of PeCa patients with a potential of further markers to improve prediction of MFS. […] In summary, PeCa specimens positive for HPV, CD15, and CD147 reflected patients with notably reduced MFS, with a potential of the CD147+CD15 combination without HPV in predicting survival.
  • #32 Squamous cell carcinoma of the penis | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/squamous-cell-carcinoma-of-the-penis-1?lang=us
    Squamous cell carcinoma (SCC) of the penis is an uncommon condition that often presents at an advanced stage. Imaging is more often used for staging than for the initial diagnosis. It is the commonest histological subtype of penile cancer. […] The disease is commonly diagnosed belatedly, as psychological reasons hinder patients visits to their physicians for clinical assessment, often rendering therapies limited in terms of satisfactory results. […] Markers have been shown to predict survival. Positive p53 is associated with a poor prognosis. […] Concerning invasive SCCs, p16 (INK4a) was found to be strongly correlated to good prognosis, excellent reproducibility, and increased cancer-specific survival (CSS) overall. […] Numerous therapeutic approaches can be employed, ranging from surgical and radiotherapeutic interventions for advanced cases, to chemotherapeutic agent administration for pre-malignant alterations (penile intraepithelial neoplasia (PeIN)).
  • #33
    https://discovery.ucl.ac.uk/id/eprint/10169098/
    Developing novel prognostic indicators for the management of metastatic penile cancer. […] The prognosis of this disease is dictated by the presence of metastasis in the inguinal lymph nodes – currently the only reliable prognostic indicator. […] Following the case-control study analysis of patients with metastatic and non-metastatic penile cancer (n=100), I identified that sarcopenia significantly reduced overall survival (OS) in those with metastatic disease. A larger cohort analysis [n=338,Metastatic(114)-Non-Metastatic(193)-pN1-N2(31)] identified that sarcopenia reduced OS irrespective of the presence of metastatic disease. […] We finally produced a penile cancer prognosis nomogram predicting 2-year OS incorporating Sarcopenia(TMA), Charlson Comorbidity Index, Lymph node involvement, Distant metastases and Sarcomatoid SCC subtype as variables. […] Although further validation of this frailty marker is advisable, sarcopenia has proven in this thesis, that it can be used as a prognostic indicator on its own as well as in a predictive Nomogram to risk-stratify patients with penile cancer at the time of their diagnosis.
  • #34
    https://discovery.ucl.ac.uk/id/eprint/10169098/
    Developing novel prognostic indicators for the management of metastatic penile cancer. […] The prognosis of this disease is dictated by the presence of metastasis in the inguinal lymph nodes – currently the only reliable prognostic indicator. […] Following the case-control study analysis of patients with metastatic and non-metastatic penile cancer (n=100), I identified that sarcopenia significantly reduced overall survival (OS) in those with metastatic disease. A larger cohort analysis [n=338,Metastatic(114)-Non-Metastatic(193)-pN1-N2(31)] identified that sarcopenia reduced OS irrespective of the presence of metastatic disease. […] We finally produced a penile cancer prognosis nomogram predicting 2-year OS incorporating Sarcopenia(TMA), Charlson Comorbidity Index, Lymph node involvement, Distant metastases and Sarcomatoid SCC subtype as variables. […] Although further validation of this frailty marker is advisable, sarcopenia has proven in this thesis, that it can be used as a prognostic indicator on its own as well as in a predictive Nomogram to risk-stratify patients with penile cancer at the time of their diagnosis.
  • #35 Prognosis and survival for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival
    Penile cancers that have a lower grade have a better prognosis than those with a higher grade. Tumours on the foreskin or glans (head) of the penis tend to be lower grade. Most tumours that affect the shaft of the penis tend to be higher grade. The higher the grade of the tumour, the higher the chance that the cancer has spread (metastasized) to the lymph nodes. […] Some types of penile cancer have a better prognosis. Verrucous carcinoma and basal cell carcinoma are usually low grade, rarely spread to other parts of the body and have a good prognosis. Melanoma of the penis tends to grow and spread more quickly and is often at an advanced stage when diagnosed. […] Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
  • #36 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for penile cancer is 65%. This means that about 65% of men diagnosed with penile cancer will survive least 5 years. […] Generally, the earlier penile cancer is diagnosed and treated, the better the outcome. […] The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes.
  • #37 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival statistics for penile cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for penile cancer is 65%. This means that about 65% of men diagnosed with penile cancer will survive least 5 years. […] Generally, the earlier penile cancer is diagnosed and treated, the better the outcome. […] The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes.
  • #38 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival by stage of penile cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer, but who share similar characteristics (such as age and sex). […] Penile cancer is confined to the penis (stages 0 to 2). 85% […] Penile cancer has spread to lymph nodes but not distant areas (stage 3). 59% […] Penile cancer has spread to distant areas in the body (stage 4). 11%. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.
  • #39 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival by stage of penile cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer, but who share similar characteristics (such as age and sex). […] Penile cancer is confined to the penis (stages 0 to 2). 85% […] Penile cancer has spread to lymph nodes but not distant areas (stage 3). 59% […] Penile cancer has spread to distant areas in the body (stage 4). 11%. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.
  • #40 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival by stage of penile cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer, but who share similar characteristics (such as age and sex). […] Penile cancer is confined to the penis (stages 0 to 2). 85% […] Penile cancer has spread to lymph nodes but not distant areas (stage 3). 59% […] Penile cancer has spread to distant areas in the body (stage 4). 11%. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.
  • #41 Survival statistics for penile cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/penile/prognosis-and-survival/survival-statistics
    Survival by stage of penile cancer is reported as 5-year relative survival. Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer, but who share similar characteristics (such as age and sex). […] Penile cancer is confined to the penis (stages 0 to 2). 85% […] Penile cancer has spread to lymph nodes but not distant areas (stage 3). 59% […] Penile cancer has spread to distant areas in the body (stage 4). 11%. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.
  • #42 Penile Cancer: Your Chances for Recovery (Prognosis) | Saint Luke’s Health System
    https://www.saintlukeskc.org/health-library/penile-cancer-your-chances-recovery-prognosis
    Prognosis is the word your healthcare team may use to describe your chances of recovering from cancer. Or it may mean your likely outcome from cancer and cancer treatment. […] A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. […] If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. This means you’re expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. […] The following are survival rates for penile cancer, published by the American Cancer Society. These come from statistics compiled by the National Cancer Institute: For cancers that have not spread outside the penis, the 5-year survival rate is about 85%. For cancers that have spread into nearby areas or lymph nodes, the 5-year survival rate is about 59%. For cancers that have spread to other parts of the body, the 5-year survival rate is about 11%. […] When penile cancer is found early, its treatment is simple and works as best it can. The treatment is less likely to cause side effects or complications.
  • #43 Survival Rates for Penile Cancer | American Cancer Society
    https://www.cancer.org/cancer/types/penile-cancer/detection-diagnosis-staging/survival-rates.html
    Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares men with the same type and stage of penile cancer to men in the overall population. […] The SEER database tracks 5-year relative survival rates for penile cancer in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. […] These numbers dont take everything into account. […] Men now being diagnosed with penile cancer may have a better outlook than these numbers show.
  • #44 Survival Rates for Penile Cancer | American Cancer Society
    https://www.cancer.org/cancer/types/penile-cancer/detection-diagnosis-staging/survival-rates.html
    Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares men with the same type and stage of penile cancer to men in the overall population. […] The SEER database tracks 5-year relative survival rates for penile cancer in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. […] These numbers dont take everything into account. […] Men now being diagnosed with penile cancer may have a better outlook than these numbers show.
  • #45 Survival Rates for Penile Cancer | American Cancer Society
    https://www.cancer.org/cancer/types/penile-cancer/detection-diagnosis-staging/survival-rates.html
    Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares men with the same type and stage of penile cancer to men in the overall population. […] The SEER database tracks 5-year relative survival rates for penile cancer in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. […] These numbers dont take everything into account. […] Men now being diagnosed with penile cancer may have a better outlook than these numbers show.
  • #46 Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis | International Journal of Impotence Research
    https://www.nature.com/articles/s41443-024-00842-5
    Penile cancer (PeCa) is rare, and the oncological outcomes in younger men are unclear. We aimed to analyse and compare oncological outcomes of men age 50 years (y) and 50 years with PeCa. Overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and metastasis-free survivals (MFS) were estimated using KaplanMeier plots and compared using log-rank tests. OS at 2 years: 50y, 86%50y, 80.6%; 5 years: 50y, 78.1%, 50y, 63.1%; 10 years: 50y, 72.3%, 50y, 45.6% (p=0.01). DSS at 2 years: 50y, 87.2%50y, 87.8%; 5 years: 50y, 80.9%50y, 78.2%; 10 years: 50y, 78%, 50y, 70.9% (p=0.74). RFS was 93.1% in the 50y group (vs. 50y, 96.5%) at 2 year, and 90% (vs. 50y, 88.5%) at 5 years, p=0.81. Within the 50y group, 2 years and 5 years MFS was 93% (vs. 50y, 96.5%), and 89.5% (vs. 50y, 92.7%) respectively, (p=0.40). There were no statistical significance in DFS, RFS and MFS in men age 50y and 50y. PeCa in younger patients is fatal, public awareness and patient education are crucial for early detection and management.
  • #47 Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis | International Journal of Impotence Research
    https://www.nature.com/articles/s41443-024-00842-5
    Penile cancer (PeCa) is rare, and the oncological outcomes in younger men are unclear. We aimed to analyse and compare oncological outcomes of men age 50 years (y) and 50 years with PeCa. Overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and metastasis-free survivals (MFS) were estimated using KaplanMeier plots and compared using log-rank tests. OS at 2 years: 50y, 86%50y, 80.6%; 5 years: 50y, 78.1%, 50y, 63.1%; 10 years: 50y, 72.3%, 50y, 45.6% (p=0.01). DSS at 2 years: 50y, 87.2%50y, 87.8%; 5 years: 50y, 80.9%50y, 78.2%; 10 years: 50y, 78%, 50y, 70.9% (p=0.74). RFS was 93.1% in the 50y group (vs. 50y, 96.5%) at 2 year, and 90% (vs. 50y, 88.5%) at 5 years, p=0.81. Within the 50y group, 2 years and 5 years MFS was 93% (vs. 50y, 96.5%), and 89.5% (vs. 50y, 92.7%) respectively, (p=0.40). There were no statistical significance in DFS, RFS and MFS in men age 50y and 50y. PeCa in younger patients is fatal, public awareness and patient education are crucial for early detection and management.
  • #48 Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis | International Journal of Impotence Research
    https://www.nature.com/articles/s41443-024-00842-5
    The 5 years OS was higher for patients 50y compared to 50y, 78.1% vs. 63.1% (p0.001), respectively, but the DSS at 5 years was similar, 50y, 80.9% vs. 50y 78.2% (p=0.74), respectively. This is not a surprise, representing that older patient died more from other causes compared to younger adults, who were more likely to be fitter and healthier. Overall, this imply that PeCa can be fatal in all age groups, including young patients. Therefore, clinicians should not underestimate the aggressiveness of PeCa in young patients and research and management should focus on preventing PeCa and early detection.
  • #49 Prophylactic Lymphadenectomy in Patients with Penile Cancer: Is Sooner Better?
    https://www.mdpi.com/2673-4397/3/4/25
    The survival of penile cancer patients is strictly related to the timing of prophylactic pelvic lymph node dissection. All patients at high risk of nodal metastasis should be offered lymph node dissection within three months of diagnosis, until new predicting tools are validated. […] The inguinal lymph node status at the moment of penile cancer diagnosis and its early management seem to have a pivotal role in the therapeutic approach to penile cancer patients. Several authors demonstrated that patients’ survival is determined by the inguinal lymph node status at the time of diagnosis. […] International guidelines suggest performing an accurate inguinal and pelvic lymph node excision within 3 months of the initial diagnosis. This recommendation is based on the association between the presence of lymph node metastases and patients’ survival rates.
  • #50 Prophylactic Lymphadenectomy in Patients with Penile Cancer: Is Sooner Better?
    https://www.mdpi.com/2673-4397/3/4/25
    The survival of penile cancer patients is strictly related to the timing of prophylactic pelvic lymph node dissection. All patients at high risk of nodal metastasis should be offered lymph node dissection within three months of diagnosis, until new predicting tools are validated. […] The inguinal lymph node status at the moment of penile cancer diagnosis and its early management seem to have a pivotal role in the therapeutic approach to penile cancer patients. Several authors demonstrated that patients’ survival is determined by the inguinal lymph node status at the time of diagnosis. […] International guidelines suggest performing an accurate inguinal and pelvic lymph node excision within 3 months of the initial diagnosis. This recommendation is based on the association between the presence of lymph node metastases and patients’ survival rates.
  • #51 Prophylactic Lymphadenectomy in Patients with Penile Cancer: Is Sooner Better?
    https://www.mdpi.com/2673-4397/3/4/25
    The survival of penile cancer patients is strictly related to the timing of prophylactic pelvic lymph node dissection. All patients at high risk of nodal metastasis should be offered lymph node dissection within three months of diagnosis, until new predicting tools are validated. […] The inguinal lymph node status at the moment of penile cancer diagnosis and its early management seem to have a pivotal role in the therapeutic approach to penile cancer patients. Several authors demonstrated that patients’ survival is determined by the inguinal lymph node status at the time of diagnosis. […] International guidelines suggest performing an accurate inguinal and pelvic lymph node excision within 3 months of the initial diagnosis. This recommendation is based on the association between the presence of lymph node metastases and patients’ survival rates.
  • #52 Prophylactic Lymphadenectomy in Patients with Penile Cancer: Is Sooner Better?
    https://www.mdpi.com/2673-4397/3/4/25
    The EAU guidelines highlight that a delay in nodal management of more than 3 to 6 months may reduce disease-free survival. However, the strength of the EAU recommendation for a complete inguinal and pelvic nodal dissection within 3 months of diagnosis is weak, and the level of evidence is 3. […] The aim of this article is to review all existing data on the impact of the timing of inguinal and pelvic prophylactic lymph node dissection on the outcomes in patients with penile cancer.
  • #53 Improved outcome in penile cancer with radiologically enhanced stratification protocol for lymph node staging procedures: a study in 316 inguinal basins with a mean follow-up of 5 years | BMC Urology | Full Text
    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01303-9
    Lymph node metastasis is the main determinant of survival in penile cancer patients. […] The performance of DSNB improved with enhanced radiological stratification of patients to either DSNB or ILND. […] Lymph node (LN) metastasis is the single most important prognostic factor in patients with squamous cell carcinoma of the penis (SCCp). […] Patients with pathologically node-negative (pN0) disease have been reported to have excellent long-term survival. […] The overall survival (OS) of patients with pN0 and pN+disease is 119 and 54 months, respectively. […] There was also a difference in overall survival depending on which staging investigation was done at the outset (i.e., DSNB vs ILND (108 vs 72 months, p0.0001)). […] To our knowledge this is the first paper to report survival data in all lymph node staging procedure in penile cancer.
  • #54 Improved outcome in penile cancer with radiologically enhanced stratification protocol for lymph node staging procedures: a study in 316 inguinal basins with a mean follow-up of 5 years | BMC Urology | Full Text
    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01303-9
    Lymph node metastasis is the main determinant of survival in penile cancer patients. […] The performance of DSNB improved with enhanced radiological stratification of patients to either DSNB or ILND. […] Lymph node (LN) metastasis is the single most important prognostic factor in patients with squamous cell carcinoma of the penis (SCCp). […] Patients with pathologically node-negative (pN0) disease have been reported to have excellent long-term survival. […] The overall survival (OS) of patients with pN0 and pN+disease is 119 and 54 months, respectively. […] There was also a difference in overall survival depending on which staging investigation was done at the outset (i.e., DSNB vs ILND (108 vs 72 months, p0.0001)). […] To our knowledge this is the first paper to report survival data in all lymph node staging procedure in penile cancer.
  • #55 Improved outcome in penile cancer with radiologically enhanced stratification protocol for lymph node staging procedures: a study in 316 inguinal basins with a mean follow-up of 5 years | BMC Urology | Full Text
    https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01303-9
    We have shown that standardisation of ultrasound reporting and use of cross-sectional imaging results to stratify patients to cN0 and cN+disease improves the outcome of lymph node staging procedures. […] We also report comprehensive data of all staging lymph node surgery in penile cancer for the first time, with overall lymph node metastasis rate of 30.3%. […] We also for the first-time report mean overall survival of 85.6% and CSS of 100% in pN0 patients following DSNB.
  • #56 Ten-year surgical experiences with penile cancer at a tertiary care hospital in northwestern Tanzania: a retrospective study of 236 patients | World Journal of Surgical Oncology | Full Text
    https://wjso.biomedcentral.com/articles/10.1186/s12957-015-0482-0
    The overall prognosis in all stages of penile cancer is known to depend largely upon the presence or absence of inguinal lymph node metastases. […] The follow-up of patients in this study was generally poor, and data on long-term survival were not available. […] Early recognition and aggressive treatment of penile cancer and close follow-up are urgently needed to improve outcomes in our environment.
  • #57 Ten-year surgical experiences with penile cancer at a tertiary care hospital in northwestern Tanzania: a retrospective study of 236 patients | World Journal of Surgical Oncology | Full Text
    https://wjso.biomedcentral.com/articles/10.1186/s12957-015-0482-0
    The overall prognosis in all stages of penile cancer is known to depend largely upon the presence or absence of inguinal lymph node metastases. […] The follow-up of patients in this study was generally poor, and data on long-term survival were not available. […] Early recognition and aggressive treatment of penile cancer and close follow-up are urgently needed to improve outcomes in our environment.
  • #58 Predictors of inguinal lymph node metastasis in penile cancer patients | CMAR
    https://www.dovepress.com/predictors-of-inguinal-lymph-node-metastasis-in-penile-cancer-patients-peer-reviewed-fulltext-article-CMAR
    Predictors of inguinal lymph node metastasis (LNM) is one of the most significant prognostic factors for patients with penile cancer. […] Current meta-analysis conclusively identified valuable predictors of inguinal LNM for patients with penile cancer. […] The intrinsic link between these predictors needs to be further investigated to create an accurate mathematical prediction model for LNM. […] The presence of inguinal lymph node metastasis (LNM) is one of the most significant prognostic factors for patients with penile cancer. […] Therefore, optimal management of inguinal lymph nodes is crucial for long-term survival after local treatment of the primary tumor. […] Accurate inguinal LNM prediction could pinpoint patients who are the best candidates for inguinal lymphadenectomy, which could not only achieve the best survival rate for patients with occult metastasis but also avoid unnecessary treatment for patients with a low risk of developing LNM.
  • #59 Penile cancer: prognostic factors for lymph node involvement—a narrative review – Li – AME Medical Journal
    https://amj.amegroups.org/article/view/7693/html
    The mode and clinical significance of LNM of penile cancer have been determined. The prediction of inguinal LNM before surgery has remained a focus of research. Accurate prediction of LNM can avoid overtreatment and missed diagnosis. […] At present, clinicopathological factors, such as the staging and grading of the primary lesion, are still important factors for predicting LNM. […] The exploration of noninvasive haematological indicators is one of the important research directions for future preoperative research. […] The use of single or combined haematological indicators can achieve an accurate prediction before the treatment of the primary tumour and surgery, which will greatly improve the treatment accuracy of patients and facilitate the rational use of medical resources.
  • #60 The impact of the tumor microenvironment on the survival of penile cancer patients | Scientific Reports
    https://www.nature.com/articles/s41598-024-70855-z
    PeCa is a rare entity with rising incidence rates due to increased infections with human papillomaviruses (HPV). […] The candidate biomarkers HPV, p63, CD15, DKK1, and CD147 linked a tumor-promoting TME with a higher TNM classification reflecting more aggressive and metastasizing cancers. […] There is a notable predictive potential regarding the survival of patients with biomarker profiles beyond the potency of the individual biomarker. […] After deciphering relevant interdependencies, the HPV+CD147+CD15+status was the most potent profile predicting metastasis-free survival of PeCa patients. […] The results of this report underscore the need for analysis of the TME and the development of multi-parameter composite scores that reflect fundamental cancer-immune relationships to tailor therapeutic interventions based on actual cancer immune dynamics.

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